Ozempic
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Full disclosure: I read about half of the article @Steve-Miller linked, and only the headline for @Bernard 's article....
But I don't understand pharmaceutical pricing.
I take a daily migraine prevention medicine. Apparently, the price is $1000-1500/month. I have a zero dollar copay. I also have an "emergency" migraine med (called abortive because it stops a migraine if one starts, and btw is not a painkiller). This one is even more expensive because it's something like $1300 for 9 pills. My copay for this is also zero dollars. These meds are not available as generics yet.
I don't understand why they're so expensive, and then how it is that I pay zero dollars for them.
These meds have been transformative for me, btw. Truly life changing.
So I'm very sympathetic to the prescription needs of others.
/threaddrift
/morethreaddrift
Ozempic was the world’s second-highest-selling drug in 2024.
I wonder what the first highest selling drug was.
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Interesting, and yes, complicated. Another sobering read, albeit with a slightly hyped headline: Ozempic mania's billions in bills are coming for US taxpayers
Another good article. Thanks. Two more wrinkles:
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Ozempic costs about $100/mo in Europe and $1200/mo in the US. The argument is (and it’s always the same argument) that they have to charge more in the US to recoup their R and D costs. Only one problem -Novo Nordisk is a Danish company.
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The first article talks about out how hard GLP 1 drugs are to make, but compounding pharmacies are selling them for $200-300/ month. Who is making the stuff?
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Full disclosure: I read about half of the article @Steve-Miller linked, and only the headline for @Bernard 's article....
But I don't understand pharmaceutical pricing.
I take a daily migraine prevention medicine. Apparently, the price is $1000-1500/month. I have a zero dollar copay. I also have an "emergency" migraine med (called abortive because it stops a migraine if one starts, and btw is not a painkiller). This one is even more expensive because it's something like $1300 for 9 pills. My copay for this is also zero dollars. These meds are not available as generics yet.
I don't understand why they're so expensive, and then how it is that I pay zero dollars for them.
These meds have been transformative for me, btw. Truly life changing.
So I'm very sympathetic to the prescription needs of others.
/threaddrift
/morethreaddrift
Ozempic was the world’s second-highest-selling drug in 2024.
I wonder what the first highest selling drug was.
Internet search says #1 worldwide is Keytruda - a cancer drug. My guess is is that the ranking is based in $ value - it’s fabulously expensive.
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I wonder if we've created a problem with the diets we follow, and are solving that problem with very expensive GLP-1 meds. Would eating differently accomplish the same thing? At least for some people?
Interesting podcast about ultra-processed foods:
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I wonder if we've created a problem with the diets we follow, and are solving that problem with very expensive GLP-1 meds. Would eating differently accomplish the same thing? At least for some people?
Interesting podcast about ultra-processed foods:
I wonder if we've created a problem with the diets we follow, and are solving that problem with very expensive GLP-1 meds. Would eating differently accomplish the same thing? At least for some people?
Almost certainly yes, probably for a fair number of people.
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it. To say nothing of the knowledge that would be needed.
One other issue is the role of the gut microbiome in obesity, something I've seen mentioned but don't know a lot about. What I mean is, there may be other causes of obesity that just eating differently will not solve.
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Would eating differently accomplish the same thing
The answer appears to be yes for some people, no for others. It appears to depend somewhat on how much processed food was in the diet before switching to something like Mediterranean.
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Interesting podcast about ultra-processed foods
Really good information here. Thanks for posting it.
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Would eating differently accomplish the same thing
The answer appears to be yes for some people, no for others. It appears to depend somewhat on how much processed food was in the diet before switching to something like Mediterranean.
@Steve-Miller said in Ozempic:
Would eating differently accomplish the same thing
The answer appears to be yes for some people, no for others. It appears to depend somewhat on how much processed food was in the diet before switching to something like Mediterranean.
Definitely the case that metabolism and nutrition are complex topics and there isn't a one-size-fits-all solution. We need to be multi-faceted in our approach, rather than relying heavily on high tech pharmaceuticals to manage obesity. People shouldn't expect to be able to stop taking the drugs. I heard a GLP-1 expert say that obesity is a chronic disease, and like other chronic diseases when you stop the treatment, the problem resurfaces.
I'm not sure lifelong dependence on GLP-1s is a sustainable approach. as the sole strategy.
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Again true for some and not for others.
One thing being on OZ teaches you is what you should be eating vs. what you should not. It’s a stern taskmistress too - eat something highly processed, greasy, or overly sweet and you get sick, sometimes very sick. Stay hydrated and eat your fiber or you’ll get constipation. Eating too much at a sitting also makes you sick. Half a sandwich is plenty.
Sounds horrible, right? It’s not, once you figure these things out, and it works. The trick then, and some people seem able to do it, is to continue these habits once you discontinue the treatment.
It can be done but it’s not always easy.
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I wonder if we've created a problem with the diets we follow, and are solving that problem with very expensive GLP-1 meds. Would eating differently accomplish the same thing? At least for some people?
Almost certainly yes, probably for a fair number of people.
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it. To say nothing of the knowledge that would be needed.
One other issue is the role of the gut microbiome in obesity, something I've seen mentioned but don't know a lot about. What I mean is, there may be other causes of obesity that just eating differently will not solve.
@ShiroKuro said in Ozempic:
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it.
I’m going to disagree here. Changing the mindset is difficult, but except in extreme cases of poverty obtaining the food is not. A few anecdotes, if I may.
My sister works at a food bank that is nicely supplied with the good stuff. What she finds is that their patrons don’t want the good stuff (artisan bread from local bakeries, fruit, veg, etc. from government programs and various farms, whole wheat things, beans, rice) they want processed and snack foods. White bread, chips, soda, cookies, packaged meals. A lot of the fresh stuff goes to waste. Reasons include that they just don’t like the unprocessed stuff or that they deserve better - an argument I find maddening.
I’ve spoken before of the toddlers. Great people, salt of the Earth, lousy diets. All of them struggle with weight issues, some to a rather extreme extent, and they’re teaching their kids to be the same. Jane (Mom) makes an attempt - always lays out veg and fruit for Sunday supper - but few eat it. Several won’t eat anything green, or fruit, or beans. Lots of snacks before dinner - all delicious but all highly processed. Great scratch cooked food but lots of gravy. Crazy rich desserts. Big portions, lots of butter.
One went on Mounjaro and lost some 80 pounds. She’s happy about it and her diabetes is in remission, as are any number of other medical issues, but she still craves brownies and won’t eat vegetables. Another is on OZ and progressing nicely but is about to bail on it because he feels lousy when he eats the food (pizza, mostly) he really likes. This sort of thing is hard to fix, and advertising makes it hard to even modify.
I live on the border of two towns, the one to the south that is heavily Appalachian, older, and lower income; and a more affluent suburb to the north. The difference in grocery stores - and grocery carts - is striking.
The main grocery store to the south caters to the tastes of the locals - and of course they do. Aisles and aisles of soda, candy, chips, and boxed meals. Limited produce, very little meat. Lots of bacon and sausage, beer, heat and serve stuff. None of it is cheap, but it’s what they want.
Their carts reflect this, and sometimes I wonder what keeps them alive. That has a name BTW, “cart shaming”. I’m supposed to feel bad about it but I don’t and I keep it to myself. The store also has plenty of healthy options but they’re hard to find. If their patrons wanted them they’d be displayed more prominently.
To the north are stores more like the ones I was used to seeing in CA. More produce, more kinds of rice, more staples, better selection of breads and such. Still aisles and aisles of questionable choices but more of the better choices featured prominently. The carts tend to reflect this and the clientele at least appear to be healthier.
Education, maybe? Perhaps, but it’s going to be mighty tough to get people to change, particularly when they’re bombarded with advertising 24/7. Equally important is that people have a right to spend their money as they please and eat what they like.
It’s complicated.
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Agreed. Add in that healthy food is generally an interest that comes along later in life when you start to understand the consequences of the alternative. But I think Steve is right in that healthy food is available most places. Getting people to eat it is a different issue, especially when they were not raised on it.
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The only person telling me what I should and should not be eating is my doctor. I do not believe the government should be in the doctor's office whether that be reproductive health or any other health issue. I'm not against the government issuing pamphlets on healthy eating and healthy lifestyle choices, but gross generalizations need to go, as do nanny state nagging. There are likely as many reasons for being overweight as there are numbers of people. (There was a NYT article about this not too long ago.) Warning labels based on correlations should not even be considered for food. Information labels are non-judgemental and useful. The French eat white bread, and a lot of it. Their pastries are sine qua non, cheese is consumed daily. Raw milk. A healthy, positive attitude towards food, they celebrate it. And they allow enough time in the structure of their lives for full enjoyment. The break for lunch is two hours, men, women, and children. In the US you're lucky to get half an hour. They eat later, after the day's work is over and they respect the end of the work day. In a word, they eat to live, not the other way around. We can't afford that in the US. Sad.
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KFF did a report on the costs associated with GLP-1s.
And a Reuters report about how two-thirds of people who go on the GLP-1s are not taking them after a year.
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aumônier
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The analysis by Prime Therapeutics, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 4,255 people with commercial health plans.
Mik, you know this stuff.
What are PBMs, what do they do, how do they make their money, why do we need them, and what would be lost if we dropped them all in to a volcano?
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@ShiroKuro said in Ozempic:
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it.
I’m going to disagree here. Changing the mindset is difficult, but except in extreme cases of poverty obtaining the food is not. A few anecdotes, if I may.
My sister works at a food bank that is nicely supplied with the good stuff. What she finds is that their patrons don’t want the good stuff (artisan bread from local bakeries, fruit, veg, etc. from government programs and various farms, whole wheat things, beans, rice) they want processed and snack foods. White bread, chips, soda, cookies, packaged meals. A lot of the fresh stuff goes to waste. Reasons include that they just don’t like the unprocessed stuff or that they deserve better - an argument I find maddening.
I’ve spoken before of the toddlers. Great people, salt of the Earth, lousy diets. All of them struggle with weight issues, some to a rather extreme extent, and they’re teaching their kids to be the same. Jane (Mom) makes an attempt - always lays out veg and fruit for Sunday supper - but few eat it. Several won’t eat anything green, or fruit, or beans. Lots of snacks before dinner - all delicious but all highly processed. Great scratch cooked food but lots of gravy. Crazy rich desserts. Big portions, lots of butter.
One went on Mounjaro and lost some 80 pounds. She’s happy about it and her diabetes is in remission, as are any number of other medical issues, but she still craves brownies and won’t eat vegetables. Another is on OZ and progressing nicely but is about to bail on it because he feels lousy when he eats the food (pizza, mostly) he really likes. This sort of thing is hard to fix, and advertising makes it hard to even modify.
I live on the border of two towns, the one to the south that is heavily Appalachian, older, and lower income; and a more affluent suburb to the north. The difference in grocery stores - and grocery carts - is striking.
The main grocery store to the south caters to the tastes of the locals - and of course they do. Aisles and aisles of soda, candy, chips, and boxed meals. Limited produce, very little meat. Lots of bacon and sausage, beer, heat and serve stuff. None of it is cheap, but it’s what they want.
Their carts reflect this, and sometimes I wonder what keeps them alive. That has a name BTW, “cart shaming”. I’m supposed to feel bad about it but I don’t and I keep it to myself. The store also has plenty of healthy options but they’re hard to find. If their patrons wanted them they’d be displayed more prominently.
To the north are stores more like the ones I was used to seeing in CA. More produce, more kinds of rice, more staples, better selection of breads and such. Still aisles and aisles of questionable choices but more of the better choices featured prominently. The carts tend to reflect this and the clientele at least appear to be healthier.
Education, maybe? Perhaps, but it’s going to be mighty tough to get people to change, particularly when they’re bombarded with advertising 24/7. Equally important is that people have a right to spend their money as they please and eat what they like.
It’s complicated.
Good comments all around.
@Steve-Miller said in Ozempic:
Education, maybe? Perhaps, but it’s going to be mighty tough to get people to change, particularly when they’re bombarded with advertising 24/7. Equally important is that people have a right to spend their money as they please and eat what they like.
It’s complicated.
It certainly it is complicated!
Education, while needed, definitely won’t do it alone.
And no, as @wtg said, the high tech pharmaceutical solution isn’t sustainable either.
I don’t have any solutions. I haven’t figured out how to drop the weight I gained during the pandemic, and Mr SK, who exercises and eats more healthfully than most, is now pre-diabetic. So there you go.
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KFF did a report on the costs associated with GLP-1s.
And a Reuters report about how two-thirds of people who go on the GLP-1s are not taking them after a year.
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My guess would be that many stop because of the cost. Others stop because of side effects, some of which appear to be avoidable and others that don’t.
I also think at least some stop because they get tired of not being able to eat the way they like to eat.
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A web search lists the same reasons I did above and one more. Some people lose weight like crazy on GLP and others lose more slowly. There are generally plateaus. People who lose more slowly can get frustrated and give up.
The people who lose weight most quickly appear to be people who have a lot to lose and people with poor diets when they start. Interesting that these same people are also the ones who do well on IF routines.
